International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"Efficacy and Safety of Biologics Targeting Type 2 Inflammation in COPD: A Systematic Review and Network Meta-Analysis.","authors":"Shujie Li, Baiyi Yi, Huan Wang, Xianghuai Xu, Li Yu","doi":"10.2147/COPD.S504774","DOIUrl":"10.2147/COPD.S504774","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to comparatively evaluate the efficacy and safety profiles of biologic agents targeting type 2 inflammation in COPD.</p><p><strong>Methods: </strong>As of September 1, 2024, we identified and screened eight clinical studies evaluating biologic agents targeting type 2 inflammation for COPD treatment from multiple databases. Following data extraction, we conducted a network meta-analysis using R software to indirectly compare the efficacy and safety profiles of the five included biologic agents, incorporating visualization of the analytical results.</p><p><strong>Results: </strong>In COPD patients with elevated eosinophil levels (peripheral blood eosinophil count ≥200 cells/μL), dupilumab demonstrated significant therapeutic efficacy by: (1) reducing the annualized rate of acute exacerbations (versus placebo: -0.44; 95% CI -0.77 to -0.10), (2) decreasing SGRQ total scores (versus placebo: -3.41; 95% CI -6.00 to -0.82), and (3) increasing pre-bronchodilator FEV1 (versus placebo: 0.06 L; 95% CI 0.00 to 0.12). Benralizumab also showed clinical benefits in reducing acute exacerbation rates (10 mg versus placebo: -0.21; 95% CI -0.39 to -0.04) and improving SGRQ scores (100 mg versus placebo: -1.70; 95% CI -3.35 to -0.04). Furthermore, all five biologic agents evaluated in this network meta-analysis exhibited favorable safety profiles.</p><p><strong>Conclusion: </strong>This NMA demonstrates that both dupilumab and benralizumab show statistically significant efficacy in COPD management, particularly among patients with eosinophilic inflammation. And these biological agents maintain favorable safety profiles. Future research should focus on large-scale multicenter clinical trials, biomarker-based patient stratification, optimization of drug delivery regimens, and development of multi-target combination therapies.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2143-2159"},"PeriodicalIF":3.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CD27 on IgD-CD38-B Cells Mediates the Coprococcus-COPD Link.","authors":"Yaning Gao, Liang Chen, Jianhong Zhang, Zhengjun Wen","doi":"10.2147/COPD.S518455","DOIUrl":"10.2147/COPD.S518455","url":null,"abstract":"<p><strong>Background: </strong>The gut-lung axis, representing the communication between gut microbiota and the lungs, has been hypothesized to influence chronic obstructive pulmonary disease (COPD) development through modulation of the immune response. However, the causal role of gut microbiota in COPD and the potential mediating role of immune cells remain largely undetermined. This study aimed to uncover the causal relationship between gut microbiota and COPD and explore the potential mediating role of immune cells in this connection.</p><p><strong>Methods: </strong>This study employed a two-step Mendelian randomization (MR) analysis to investigate the causal effect of gut microbiota on COPD and explore the potential mediating role of immune cells in this relationship. The inverse variance weighted method served as the primary MR analysis method.</p><p><strong>Results: </strong>MR analyses revealed statistically significant genetic associations between 28 gut microbiota and COPD. Among these, the genus <i>Coprococcus</i> demonstrated the strongest causal effect on COPD risk, exhibiting a significant positive association (odds ratio (OR) = 1.18, 95% confidence interval (CI): 1.03-1.36, <i>P</i> = 0.03). Additionally, 15 immune cell traits displayed significant associations with <i>Coprococcus</i>. Notably, CD27 expressed on IgD^- CD38^- B cells emerged as a potential contributor to COPD development (OR = 1.04, 95% CI: 1.00-1.07, <i>P</i> = 0.03). We further explored the potential mediating effect of CD27 on IgD^- CD38^- B cells in the relationship between <i>Coprococcus</i> and COPD.</p><p><strong>Conclusion: </strong>Our MR analysis provided evidence for a causal association between gut microbiota and COPD, potentially mediated by immune cells.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2173-2182"},"PeriodicalIF":2.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Social Support, Symptom Burden, Dyspnea, Perceived Stress, Perceived Stigma, Coping Styles, and Psychological Distress in Patients with Stable COPD: A Structural Equation Model.","authors":"Xu Tian, Lijuan Yi, Xiaoling Liu, Fengli Zuo, Hongcai Shang, Jianping Zhang, Yi Ren","doi":"10.2147/COPD.S521786","DOIUrl":"10.2147/COPD.S521786","url":null,"abstract":"<p><strong>Background: </strong>Psychological distress is prevalent in patients with stable chronic obstructive pulmonary disease (COPD) and may contribute to disease progression. However, the interplay among its influencing factors remains unclear. This study aimed to explore how social support, symptom burden, dyspnea, perceived stress, perceived stigma, and coping styles impact psychological distress in stable COPD using a structural equation model (SEM).</p><p><strong>Methods: </strong>A convenience sample of 386 stable COPD patients was recruited from three tertiary hospitals in Chongqing, China. Data were collected using Distress Thermometer, Perceived Social Support Scale, COPD Assessment Test, the Modified Medical Research Council Dyspnea Score, the Perceived Stress Scale 10-item version, the Stigma Scale for Chronic Illness 8-item version, and the Simplified Coping Style Questionnaire were used for data collection. SEM was used for relationships among variables.</p><p><strong>Results: </strong>The mean psychological distress score was (3.770 ± 1.525). Positive coping style (β = -0.329, p < 0.001) and perceived social support (β = -0.750, p < 0.001) reduced psychological distress directly. In contrast, negative coping style (β = 0.360, p < 0.001), symptom burden (β = 0.317, p < 0.001), dyspnea (β = 0.396, p < 0.001), perceived stress (β = 0.268, p < 0.001), and stigma (β = 0.224, p < 0.001) increased it. Perceived social support exerted extensive indirect effects on psychological distress (total effect = -1.044) by reducing symptom burden (β = -0.681), dyspnea (β = -0.673), and negative coping style (β = -0.726), and by improving positive coping style (β = 0.781) and perceived stress (β = -0.688). Similarly, symptom burden indirectly influenced distress via coping styles (indirect effect = 0.290).</p><p><strong>Conclusion: </strong>Psychological distress in stable COPD patients is influenced by interrelated factors, with perceived social support playing a central role. Healthcare interventions should focus on improving coping strategies, managing symptoms, and strengthening social support to alleviate distress.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2183-2198"},"PeriodicalIF":3.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life's Crucial 9 Score as a Novel Role for Chronic Obstructive Pulmonary Disease Screening.","authors":"Wenqiang Li, Youli Wen, Yuting Fan, Zefu Hu, Zhiping Deng, Qian Huang","doi":"10.2147/COPD.S515649","DOIUrl":"10.2147/COPD.S515649","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate the association between the Life's Crucial 9 (LC9) score and chronic obstructive pulmonary disease (COPD) in middle-aged and older adults.</p><p><strong>Patients and methods: </strong>We screened the NHANES database for data from 2007-2018. Logistic regression analysis and subgroup analysis were used to explore the association between LC9 score and COPD in middle-aged and older adults. Additionally, restricted cubic spline (RCS) was plotted to visually depict the dose-response relationship between the two.</p><p><strong>Results: </strong>A total of 12,030 participants were included, of whom 815 had COPD. After multivariate adjustment, the LC9 score was found to be inversely associated with COPD diagnosis. The RCS visually demonstrated a linear decreasing relationship between the two. Furthermore, subgroup analysis revealed no significant interaction across different subgroups, except for education level.</p><p><strong>Conclusion: </strong>The LC9 score is linearly and inversely associated with COPD diagnosis. Higher LC9 scores are associated with a lower COPD diagnosis in individuals aged 40 and above.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2161-2171"},"PeriodicalIF":2.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sub-Optimal Chronic Obstructive Pulmonary Disease (COPD) Management in India: Findings from a Community-Based Study.","authors":"Prashant Jarhyan, Anastasia Hutchinson, Rajesh Khatkar, Dorairaj Prabhakaran, Sailesh Mohan","doi":"10.2147/COPD.S499792","DOIUrl":"10.2147/COPD.S499792","url":null,"abstract":"<p><strong>Background and objective: </strong>Despite the second most common cause of disease burden, there are few studies reporting the prevalence, awareness, and treatment rates of COPD in India.</p><p><strong>Methods: </strong>A community-based cross-sectional study was conducted among people aged ≥40 years residing in rural and urban areas of Sonipat district in North India using a multistage random sampling technique. COPD was defined as self-reported physician diagnosed COPD, emphysema, chronic bronchitis or being on treatment for COPD. Additional cases were detected using a validated sequential screening strategy, ie, administering the Lung Function Questionnaire (LFQ) followed by the pocket spirometry and confirmation by post-bronchodilation spirometry. Awareness was defined as self-reported diagnosed cases of COPD or self-reported treatment. Treatment was defined as self-reported intake of oral or inhalational corticosteroids and/or bronchodilators. Trained Community Health Workers interviewed the study participants using a paper-based validated questionnaire, screened for COPD with the LFQ and conducted the pocket spirometry. Confirmation of COPD using post-bronchodilation gold standard spirometry was conducted by trained physician researchers. Age-standardized estimates were calculated for the prevalence, awareness, and treatment of COPD.</p><p><strong>Results: </strong>The overall age-standardised prevalence of COPD in our study was 8.6% (95% CI: 7.5-9.8) with higher prevalence in men and rural population. The overall awareness of COPD was 75.1% (95% CI: 68.5-80.7) with lower awareness among people who ever-smoked [33.9% (32.0-35.8)], currently smoked [29.6% (27.8-31.5)] and among those with post-bronchodilator confirmed diagnosis of mild COPD (4.8%). Less than half (45.7%) of participants with COPD reported taking bronchodilators and/or corticosteroids.</p><p><strong>Conclusion: </strong>The awareness-treatment gap in COPD was high in the study population. There is a need to strengthen the public health system along with systematic training of health care providers to provide appropriate treatment to people with COPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2131-2142"},"PeriodicalIF":2.7,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comorbidities and Cause of Death in COPD Patients Compared to Non-COPD Controls: An 8-year Observational Retrospective Healthcare Claims Database Cohort Study.","authors":"Claus F Vogelmeier, Felix W Friedrich, Patrick Timpel, Nils Kossack, Joanna Diesing, Marc Pignot, Melanie Abram, Michael Gediga, Marija Halbach","doi":"10.2147/COPD.S488701","DOIUrl":"10.2147/COPD.S488701","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with COPD suffer from various comorbidities, seemingly leading to a collective increase in morbidity and mortality. However, comorbidities with COPD have been largely unreported.</p><p><strong>Patients and methods: </strong>Using healthcare claims data, only the deceased among around 250,000 COPD patients diagnosed in 2011-2018 were evaluated by cause of death (cumulative incidence without competing risk) across a period of up to eight years. Results were compared with 1:1 propensity score-matched controls. Additionally, the prevalence of comorbidities in deceased patients was compared.</p><p><strong>Results: </strong>On average, deceased COPD patients and matched controls lived to be 75.7 and 78.0 years, respectively, and COPD patients had more comorbidities prior to death (mean 4.53 and 3.65). Both respiratory and cardiovascular-related deaths were more likely in COPD patients than in their matched controls (3.3 and 1.6 percentage points higher after eight years), and this was more extreme (9.8 and 3.4 percentage points higher, respectively) in the COPD subgroup with multiple/severe exacerbations; cumulative incidence of death increased with increasing COPD severity. Comorbidity prevalence, especially cardiovascular-related, was higher in COPD patients than in matched controls; COPD patients had a 42% higher risk of heart failure (RR 1.42; 1.38-1.47), 30% higher risk of ischemic heart disease (RR 1.30; 1.25-1.35), and 27% increased risk of atrial fibrillation (RR 1.27; 1.21-1.32).</p><p><strong>Conclusion: </strong>In this real-world observational retrospective cohort study, we found patients with COPD died at a younger age, and developed more comorbidities, than matched controls.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2117-2130"},"PeriodicalIF":2.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12214430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Silico Lung Deposition Profiles of Three Single-Inhaler Triple Therapies in Patients with COPD Using Functional Respiratory Imaging.","authors":"Dave Singh, Nicolas Roche, Libo Wu, Hosein Sadafi, Jan De Backer, Navid Monshi Tousi, Jonathan Marshall","doi":"10.2147/COPD.S510214","DOIUrl":"10.2147/COPD.S510214","url":null,"abstract":"<p><strong>Introduction: </strong>Inhalation is the foundational route for administering pharmacological treatments for chronic obstructive pulmonary disease (COPD). Given the relevance of both large and small airways in COPD, lung distribution deposition characteristics of different inhaler options could influence treatment effects. This study evaluated the total deposition of 3 single-inhaler triple therapies in the large and small airways.</p><p><strong>Methods: </strong>This study assessed lung deposition of different inhalers using in silico functional respiratory imaging from 20 patients with COPD. The first part evaluated budesonide/glycopyrronium/formoterol fumarate dihydrate (BGF) pressurized metered-dose inhaler (pMDI), beclomethasone dipropionate/glycopyrronium/formoterol fumarate dihydrate (BDP/G/F) pMDI, and fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) dry powder inhaler (DPI) at 30 L/min. The second part assessed BGF pMDI and FF/UMEC/VI DPI at 60 L/min.</p><p><strong>Results: </strong>All 3 inhalers had different in silico total lung and large and small airways deposition profiles at 30 L/min, with BGF pMDI (54.8% to 57.7%) demonstrating a higher deposition profile across each therapeutic component versus BDP/G/F pMDI (38.6% to 40.5%) and FF/UMEC/VI DPI (24.0% to 36.1%), respectively. Similarly, at 60 L/min, the total deposition of all 3 components of BGF pMDI (57.2% to 58.5%) remained higher compared with FF/UMEC/VI DPI (19.8% to 34.1%).</p><p><strong>Conclusion: </strong>These findings provide quantitative insights into relative lung deposition distribution profiles and efficiency of delivery for 3 inhaler options. Further research is needed to understand if these deposition patterns could translate into real-world clinical effectiveness differences.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2103-2116"},"PeriodicalIF":2.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12214429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Risk Factors of Tuberculosis-Associated Chronic Obstructive Pulmonary Disease.","authors":"Dong-Hyun Joo, Min Chul Kim, Sooim Sin, Hye-Rin Kang, Jin Hwa Song, Hyung-Jun Kim, Myung Jin Song, Byoung Soo Kwon, Yeon Wook Kim, Yeon Joo Lee, Jong Sun Park, Jae Ho Lee, Ye Jin Lee","doi":"10.2147/COPD.S523732","DOIUrl":"10.2147/COPD.S523732","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic obstructive pulmonary disease (COPD) is influenced by multiple factors. Varying prevalences of tuberculosis-associated COPD exist. However, studies on its incidence or risk factors are limited. We evaluated the incidence of tuberculosis-associated COPD and compare the characteristics of patients with and without COPD.</p><p><strong>Patients and methods: </strong>This multicenter, retrospective cohort study included 351 patients treated with anti-tuberculosis drugs for more than 6 months in four hospitals in Korea, followed for 11 years (132 months). The follow-up duration was divided into quartiles (Q1-Q4) to evaluate the change in the incidence of COPD over time. Clinical data and radiological findings were collected, and the incidence rate ratios were compared using Poisson regression and multivariable logistic regression analysis to identify risk factors.</p><p><strong>Results: </strong>Overall, 71 participants developed tuberculosis-associated COPD, with an overall crude incidence of 20.56/1000 person-years. Patients with tuberculosis-associated COPD were older, more likely to be smokers, and had lower forced expiratory volume in 1 s (FEV1) (L) and lower FEV1/forced vital capacity. The incidence over 132 months was significantly lower than those during follow-up, with an incidence rate ratio of 0.49 (p=0.027). Multivariate analysis revealed that a tuberculosis diagnosis at an older age (adjusted odds ratio [aOR] 1.04; 95% confidence interval [CI]: 1.01-1.07), lower baseline FEV1 <80% (aOR 3.98; 95% CI: 1.92-8.24), smoking (aOR 3.23; 95% CI: 1.14-9.17), and multilobar involvement of tuberculosis (aOR 2.04; 95% CI: 1.08-3.85) were risk factors for tuberculosis-associated COPD. The incidence in the Q4 (>132 months, approximately 11years) was significantly lower than that in the Q1 (18-71 months), with incidence rate ratio of 0.49 (p= 0.027).</p><p><strong>Conclusion: </strong>Older age at tuberculosis diagnosis, lower baseline FEV1 <80%, smoking history, and multilobar involvement were identified as risk factors for tuberculosis-associated COPD. The incidence of tuberculosis-associated COPD decreased 11 years after tuberculosis treatment.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2091-2102"},"PeriodicalIF":2.7,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Obstructive Pulmonary Disease and the Management of Cardiopulmonary Risk in the UK: A Systematic Literature Review and Modified Delphi Study.","authors":"Dinesh Shrikrishna, John Steer, Beverley Bostock, Scott W Dickinson, Alicia Piwko, Sivatharshini Ramalingam, Ravijyot Saggu, Carol Ann Stonham, Robert F Storey, Clare J Taylor, Raj Thakkar, Chris P Gale","doi":"10.2147/COPD.S523865","DOIUrl":"10.2147/COPD.S523865","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is linked to increased mortality and morbidity, especially in patients with coexisting cardiovascular disease. These patients face heightened cardiopulmonary risk, which escalates further after acute exacerbations of COPD. While there is some guidance on the management of acute exacerbations of COPD, there is a lack of specific strategies for addressing cardiopulmonary risk in COPD. This program of work aimed to establish UK consensus statements and a clinical pathway for managing cardiopulmonary risk in patients with COPD, synthesizing evidence and expert input through a modified Delphi approach. A multidisciplinary Taskforce conducted a systematic review, focusing on the UK and addressing questions relating to the healthcare burden of acute exacerbations of COPD (AECOPDs), the link between AECOPDs and cardiopulmonary events, the management of cardiopulmonary risk in patients with COPD, and the guidelines and interventions implemented to optimize COPD management. The evidence identified was summarized and used to synthesize preliminary consensus statements reflecting the current situation and recommendations for action. Following iterative voting rounds, consensus was reached on 18 statements. Further to this, a clinical pathway framework to support the recognition and management of cardiopulmonary risk in patients with COPD using the consensus statements was formulated. AECOPDs were identified as a substantial healthcare burden in the UK, contributing to high mortality, frequent healthcare interactions, and elevated costs. These exacerbations were associated with cardiopulmonary events such as myocardial infarction and stroke. Most UK guidelines have focused on the respiratory management of COPD exacerbations, but lack strategies to specifically address cardiopulmonary risk, highlighting the need for integration of care. This consensus program has identified gaps in management, as well as a need to optimize care and reduce the cost of COPD management through the development of new UK policies and clinical guidance.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2073-2090"},"PeriodicalIF":2.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Does Disease Severity Affect Clinical Outcomes and Economic Burden of Patients with COPD -- A Retrospective Population-Based Cohort Study in Tianjin, China.","authors":"Lei Wang, Ke Huang, Xiaoning He, Jiahui Zhang, Ting Yang, Jing Wu","doi":"10.2147/COPD.S524647","DOIUrl":"10.2147/COPD.S524647","url":null,"abstract":"<p><strong>Introduction: </strong>Quantifying the disease burden across severity levels is essential for early intervention and effective management of chronic obstructive pulmonary disease (COPD). This study aimed to clarify the effect of severity on disease burden by comparing clinical and economic outcomes stratified by disease severity based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) in a Chinese setting.</p><p><strong>Methods: </strong>A retrospective population-based cohort study was conducted using electronic health records of 80 hospitals (2016-2019). Patients (≥40 years) diagnosed with COPD (ICD-10: J44) between 2017 and 2018 were identified and further classified into high (GOLD E) or low (GOLD A/B) exacerbation risk groups based on 12-months pre-index exacerbation history. GOLD groups A, B, and E were categorized based on exacerbation history and prior symptom burden. Clinical and economic outcomes were examined during 12-months follow-up, including incidence and time intervals between exacerbations, mortality, healthcare resource utilization, and direct medical costs.</p><p><strong>Results: </strong>Among 6759 COPD patients (mean age 68.36 ± 11.46 years, 62.4% male), patients in group E (N=2378) showed significantly worse outcomes than group A/B (N=4381): 57% higher exacerbations risk (90.5 vs 70.5%, adjusted hazard ratio [HR]=1.57; 95% CI: 1.48-1.67), 31% higher risk of all-cause mortality (11.6 vs 6.6%, HR=1.31; 95% CI: 1.10-1.57), and 1.7-fold higher COPD-related total costs (Chinese yuan [CNY] 21,156 vs 12,457, adjusted difference CNY 4238) during follow-up. Notably, the incidence rates of overall exacerbation, total costs increased progressively from group A to B to E in the year following the index date.</p><p><strong>Conclusion: </strong>Poor prognosis and high economic burden were observed among Chinese patients with COPD. Higher disease severity was associated with increased risk of exacerbation, all-cause mortality, and economic burden. These findings underscore the need for early intervention in patients with mild COPD to prevent disease progression, subsequent exacerbations, and rising economic impacts.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2061-2072"},"PeriodicalIF":2.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}